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MR. DEREK R WYNN PA
NPI 1043689441
Physician Assistant - Medical in Grangeville, ID

Active since September 16, 2015PECOS EnrolledAccepts Medicare Assignment
607 W MAIN STREET, GRANGEVILLE, ID 83530(208) 983-1700(208) 983-4665 Get Directions Write a Review

NPPES record last updated: September 16, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Derek R Wynn Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DEREK R WYNN PA (NPI 1043689441) is an individual medical provider in Grangeville, Idaho, licensed in Idaho (PA-1276) and active in the NPI registry since September 2015. He is enrolled in Medicare PECOS, is affiliated with Logan Regional Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1043689441
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. DEREK R WYNNCredential: PA
Location Address607 W MAIN STREETGrangeville, ID 83530
Mailing Address607 W Main StGrangeville, ID 83530-1345 · (208) 983-1700 · Fax (208) 983-4665
Phone(208) 983-1700
Fax(208) 983-4665
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 16, 2015
✔ NPI 1043689441 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in ID · PA-1276
607 W MAIN STREET, Grangeville, ID 83530
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Other Identifiers 3

Medicare UPIN1750336608ID
Medicare OSCAR/certification131315ID
Medicare PIN131315ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare, Select Health, University of Utah Health Plans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Derek R Wynn Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8022326503
PECOS Enrollment IDI20191218002588
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
105 services77 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
60 services58 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Logan Regional Hospital

Acute Care Hospitals · Logan, UT
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number460015
Location1400 North 500 EastLogan, UT 84341 · Cache County
Emergency services Birthing friendly

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derek Wynn's NPI number?

The NPI number for Derek Wynn is 1043689441. It was assigned to this individual provider in the NPPES registry on September 16, 2015.

Where is Derek Wynn located?

Derek Wynn practices at 607 W Main Street, Grangeville, ID 83530. The listed phone number is (208) 983-1700.

What is Derek Wynn's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Derek Wynn enrolled in Medicare?

Yes. Derek Wynn is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Derek Wynn accept?

Health plans from Molina Healthcare, Select Health and University of Utah Health Plans list Derek Wynn as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Derek Wynn affiliated with any hospitals?

According to CMS data, Derek Wynn is affiliated with Logan Regional Hospital.

When was this NPI record last updated?

The NPPES record for Derek Wynn was last updated on September 16, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.